Association between soft drink consumption and depression mediated by gut microbiome: a perspective

Mar 31, 2026East Asian archives of psychiatry : official journal of the Hong Kong College of Psychiatrists = Dong Ya jing shen ke xue zhi : Xianggang jing shen ke yi xue yuan qi kan

How gut bacteria may link soft drink drinking to depression

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Abstract

Soft drink consumption is associated with an increased risk of depression, with a multicentre cohort study showing an odds ratio of 1.081 for major depressive disorder diagnosis.

Associations between soft drink consumption and higher depression risk were consistently observed across various study designs and populations.
Evidence for artificially sweetened beverages was less consistent, indicating potentially different pathways unrelated to sugar.
In women, the association between soft drink consumption and depression risk was stronger, with an odds ratio of 1.167.
The gut microbiome may partially mediate the relationship between soft drink consumption and depression, explaining around 4% of the association.
Multiple biological pathways, including inflammation and metabolic dysregulation, are involved in the link between soft drinks and depression.

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This perspective synthesises current evidence on the association between soft drink consumption and depression, with emphasis on the gut microbiome as a potential mediating mechanism. PubMed, Scopus, and Google Scholar were searched using the following terms: 'soft drinks', 'sugar-sweetened beverages', 'carbonated beverages', 'soda', 'depression', 'depressive symptoms', 'mental health', 'gut microbiome', 'microbiota', and 'gut-brain axis'. Peer-reviewed original articles published in English between January 2000 and October 2025 were included if they involved human participants of any age (sample size ≥50 for observational studies), assessed soft drink or sugar-sweetened beverage consumption, and measured depression diagnosis, depressive symptoms, or depression severity. Associations between soft drink consumption and increased depression risk were consistently shown across multiple study designs and populations. Evidence for artificially sweetened beverages was less consistent and suggested potentially distinct, non-sugar-related pathways. A multicentre cohort study of 932 participants revealed that soft drink consumption predicted the major depressive disorder diagnosis (odds ratio = 1.081), with stronger effects in women (odds ratio = 1.167).partially mediated the soft drink-depression association, explaining approximately 4% of the association. Soft drink consumption is associated with increased depression risk through multiple biological pathways involving inflammation, metabolic dysregulation, and gut microbiome alterations. Modest effect sizes suggest the involvement of multiple interconnected mechanisms. Public health interventions to limit sugar-sweetened beverage consumption are recommended to improve physical and mental health. Healthcare providers should consider dietary assessment and counselling as part of depression prevention and treatment strategies. Eggerthella

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Association between soft drink consumption and depression mediated by gut microbiome: a perspective

Abstract

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